Category Archives: Dispute Resolution

Multi-million dollar settlements in False Claims Act (FCA) cases against long term care (LTC) facilities made headlines several times in 2017. I have blogged several times on the FCA and could not allow this trend to go without comment. We all know that the purpose of the FCA is to penalize government contractors that submit false claims for reimbursement to government programs. The penalty is triggered when anyone “knowingly presents or causes to be presented a false or fraudulent claim for payment or approval” or “knowingly makes, uses or causes to be made or used a false record or statement …

Anyone who follows this blog knows that I am an advocate for arbitration agreements because of the benefits they offer parties to a dispute. They can streamline dispute resolution, reduce costs of resolution, make the process more predictable because the parties control the terms, and allow for confidentiality, all while allowing the complainant to have his or her day in court. The availability of arbitration was initially jeopardized by the November 28, 2016 regulations from the Centers for Medicare and Medicaid Services (“CMS”), with its eleventh hour attempt to pass regulations prohibiting pre-dispute arbitration agreements in the skilled care setting. …

As the world knows, Tenth Circuit Court of Appeals Judge Neil Gorsuch is being considered for the vacancy on the United States Supreme Court created by the death of Justice Antonin Scalia. Judge Gorsuch is a conservative jurist who has opined on federal agencies overstepping their mandates. That perspective may be very helpful to an over-regulated industry, such as long term care. In October 2016, the long term care industry saw the Centers for Medicare and Medicaid Services (“CMS”) squeeze in a re-write of its regulations just before a change in administration. Some of those new regulations can be considered …

In Service Employees International Union v. Montecito Heights Healthcare & Wellness Centre, LP, Case No. 31-CA-129747, the NLRB ruled that a skilled nursing facility’s arbitration provision in its alternative dispute resolution (“ADR”) policy requiring its unionized employees to waive their right to bring class actions or to act concertedly violated federal labor law. If you are non-unionized, do not stop reading here because this ruling has the potential of being applied to non-union workplaces. The nursing facility’s ADR policy expressly prohibited “employees from joining a class action or representative action.” Relying on precedent promulgated by the NLRB in Murphy Oil …

We tend to fear that with which we are not familiar. Management companies and insurance claims managers often express unwillingness to enforce arbitration clauses in resident admission agreements (“Agreement”) because they are not familiar with the arbitration process and would prefer doing things the way they have always been done. I would like to change that response. Arbitration clauses are agreements like any other agreement. The terms of the agreements are set by the facilities and accepted or rejected by the residents. Based on how courts enforce arbitration clauses, certain language should be included; however, whether to include an arbitration …

In this second of a two-part series on arbitration clauses, we start with acknowledgement that arbitration clauses in resident admission agreements (“Agreement”) are a good practice because they give you additional means of resolution and may avoid jury trials. You have drafted your clause to include all foreseeable disputes and to require the issue of arbitrability to be decided by the arbitrator. Now, you want to ensure that your arbitration clause cannot be rejected because it violates contract law. Recall that the Federal Arbitration Act states that arbitration clauses are valid and irrevocable, except upon such grounds as exist for …

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LeClairRyan serves for-profit and not-for-profit long term care facility owners and operators across the nation, including skilled nursing facilities, assisted living facilities, retirement communities and independent living facilities. More...